| NPI | 1508226093 |
|---|---|
| Former Name | JISEL MARIE PANIAGUA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT34110) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT 291163) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2019-06-04 |